IBD Editorials

As ObamaCare Mandates Explode, So Will Insurance Costs

12/07/2012 06:47 PM ET

Health Care: The official title of ObamaCare is the "Affordable Care Act." But the rush to add coverage mandates for every health service under the sun guarantees the law will fail to live up to its name.

In a recent New York Times article, chiropractors and acupuncturists bragged about how they're getting their services mandated under ObamaCare's "essential benefits" rule. That part of the law says all insurance — which the government forces everyone to buy — has to cover certain basic benefits and leaves it up to the states to fill in a lot of the blanks.

Not surprisingly, lobbyists for provider groups are pressing state legislatures to make sure their particular service gets on that list.

And why not? It means lots of new customers not paying much, if anything, out of pocket for their treatments.

As the Times reports, chiropractor lobbyists were "out in force" to have their service "included in every state's package of essential health benefits." And acupuncture will be mandated in at least four states.

Other coverage mandates that various states have announced they plan to require under ObamaCare include weight-loss surgery and infertility treatment. These are on top of the federal mandates the Obama administration has already announced, including things like "free" preventive service and contraception coverage.

Since health care dollars don't fall from trees, each of those mandates will end up adding to the cost of insurance. Worse, these mandates will only grow over time.

State governments know this, since they have a long and sordid history of giving in to lobbyist pressure and imposing increasing coverage mandates on state-regulated insurance plans.

States currently impose 2,262 benefit mandates, up from 2,156 the year before, according to the Council for Affordable Health Insurance. There were just 850 mandates in 1992, when CAHI first started tracking them.

Among the more ridiculous are requirements that insurance cover breast implant removal, circumcision, wigs for chemotherapy patients, smoking-cessation service and varicose vein removal.

CAHI figures state mandates add 10% to 50% to the cost of insurance. A report from the Maryland Health Care Commission figures that around 20% of premiums in that state are the result of its 45 benefit mandates.

In addition to preventive-care rules, ObamaCare bans lifetime limits on coverage and puts caps on out-of-pocket costs, each of which will drive up premiums. Its requirement that insurers cover "children" up to 26 years old has already added as much as 3% to premiums, according to Towers Watson.

Along with mandated benefits, ObamaCare declares war on high-deductible health plans proved to hold costs down.

Individual plans won't be allowed to have a deductible higher than $2,000. This rule will mean that 1-in-7 workers will be forced to take a lower deductible, then pay higher insurance costs as a result.

When Nebraska tried to make a high-deductible plan its benchmark plan under ObamaCare, the administration turned the state down, saying it didn't meet the law's requirements.

Even ObamaCare backers admit its benefit mandates — along with insurance market "reforms" — will add significantly to the cost of coverage. Jonathan Gruber, who helped design ObamaCare, studied the law's effects on individual insurance policies in several states and concluded it will add 30% to those premiums.

Long ago, Obama promised that his medical overhaul would focus entirely on bringing the cost of insurance down.

But the law he's busy implementing will have the exact opposite effect.